Made available in DSpace on 2017-07-10T14:17:19Z (GMT). No. of bitstreams: 1 CAROLINA BOAMORTE.pdf: 1397771 bytes, checksum: 77780c428457cc0480306357b2380e44 (MD5) Previous issue date: 2016-06-16 / The ratio of osteoporosis in postmenopausal women is controversial, but may be a risk factor for periodontal disease, as well as having a direct or indirect role in bone due to estrogen action, since this can inhibit production of proinflammatory cytokines -inflammatory such as TNF-alpha and IL-6 that favor bone resorption. One of the alternatives in hormone replacement therapy is the isoflavone, a phyto-hormone that has established itself as replacement therapy for having a similar action to estrogen, but with protective effects against cancers, osteoporosis, among others. The objective was to evaluate the effect of isoflavone on alveolar bone of ovariectomized rats with induced periodontitis. Sixty (60) Female rats with 8 weeks of age were randomly divided into 6 groups: 1) control group (CON); 2) Bandage Group (LIG); 3) Group Ovariectomy (OVX); 4) Ovariectomia and Phytoestrogen group (OVX + FIT); 5) Ovariectomia and ligature group (OVX + LIG); 6) Ovariectomia Group, Phytoestrogen and Ligation (OVX + FIT + LIG) .All the animals received standard diet and water at will. After 70 days of life, the animals were anesthetized (xylazine 10 mg / kg and ketamine 75 mg / kg) and were placed in proper operating table, which allowed the maintenance of the mouth opening of the rats facilitating access to the teeth of the posterior region jaw. With the aid of a modified forceps and an explorer, it was placed a cotton yarn number 40 around the mandibular first molar right and left. After this procedure, after 79 days of life, the rats were submitted to anesthesia and ovariectomy surgery to mimic the absence of female sex hormones of menopause in women. Ligation served as irritating gums for 30 days and favored the accumulation of plaque, while hormone replacement therapy (isoflavone) was held for 21 days (0.25 g / kg / day sc) in the above-mentioned groups. At 100 days of life, the rats were euthanized. Macroscopic, microscopic and X-ray analyzes were performed with the left and right jaws of each rat as well with samples of gingival tissue to assess the periodontal tissues and their effects induced by hormone replacement. As a result of analysis, it was observed that the groups of phytoestrogen showed less bone loss than the groups that received no therapy isoflavone (p <0.05) and the treated groups had a higher phytoestrogen osteoblasts and osteocytes osteoclasts and lower than the groups not receiving hormone replacement therapy (p <0.05). Therefore, the isoflavone may confer a protective effect on bone loss in periodontal disease progression, compounded by osteoporosis. / A relação da osteoporose na pós-menopausa é controversa, mas pode ser um fator de risco para doença periodontal, bem como possuir uma atuação direta e indireta no tecido ósseo devido a ação do estrógeno, uma vez que este pode inibir a produção de citocinas pró-inflamatórias como o TNF-alfa e a IL-6 que favorecem a reabsorção óssea.Uma das alternativas na terapia de reposição hormonal atualmente é a isoflavona, um fito-hormônio que vem se estabelecendo como terapia substitutiva por ter sua ação similar ao estrógeno, porém com efeitos protetores contra as doenças cancerígenas, osteoporose, entre outras. Assim, o objetivo foi avaliar a ação da isoflavona no tecido ósseo alveolar de ratas ovariectomizadas com peridontite induzida. Sessenta (60) Ratas fêmeas com 8 semanas de vida foram divididas aleatoriamente em 6 grupos: 1) Grupo Controle (CON); 2) Grupo Ligadura(LIG); 3) Grupo Ovariectomia (OVX+DMSO); 4) Grupo Ovariectomia e Fitoestrógeno (OVX+FIT); 5) Grupo Ovariectomia e Ligadura (OVX+LIG+DMSO); 6) Grupo Ovariectomia, Fitoestrógeno e Ligadura (OVX+FIT+LIG).Todos os animais receberam dieta padrão e água a vontade. Aos 70 dias de vida, os animais foram anestesiados (xilazina 10 mg/Kg e quetamina 75 mg/Kg) e foram posicionados em mesa operatória apropriada, a qual permitia a manutenção da abertura bucal das ratas facilitando o acesso aos dentes da região posterior da mandíbula. Com o auxílio de uma pinça modificada e de uma sonda exploradora, foi colocado um fio de algodão número 40 ao redor do primeiro molar inferior direito e esquerdo. Após este procedimento, aos 79 dias de vida, as ratas também foram submetidas à anestesia e à cirurgia de ovariectomia para mimetizar a ausência de hormônios sexuais femininos da menopausa em mulheres. A ligadura atuou como irritante gengival por 30 dias e favoreceu o acúmulo de placa bacteriana, enquanto a reposição hormonal (isoflavona) se realizou por 21 dias (0,25g/kg/dia s.c.) nos grupos anteriormente citados. Aos 100 dias de vida, as ratas foram eutanasiadas. Foram realizadas análises macroscópica, microscópica e radiográfica com as mandíbulas esquerda e direita de cada rata, bem como com amostras do tecido gengival para avaliar os tecidos periodontais e seus efeitos induzidos pela reposição hormonal. Como resultado das análises, foi observado que os grupos com fitoestrógeno apresentaram menor perda óssea alveolar do que os grupos que não receberam terapia com isoflavona (p< 0,05), bem como os grupos tratados com fitoestrógeno apresentaram uma maior quantidade de osteoblastos e osteócitos e menor de osteoclastos do que os grupos que não receberam terapia de reposição hormonal (p<0,05). Logo, a isoflavona pode conferir um efeito protetor à perda óssea alveolar, na progressão da doença periodontal, agravada pela osteoporose.

Made available in DSpace on 2017-07-10T14:57:29Z (GMT). No. of bitstreams: 1 Karine _Figueredo da Costa.pdf: 1477303 bytes, checksum: 428fe0d7f49e8f5828d70fa92f05b2f1 (MD5) Previous issue date: 2015-02-24 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / Background and Objective: Periodontal disease is a chronic disease that affects a major population part and has been associated with systemic changes. As a result, its relationship with obesity and atherosclerosis, it is a matter of concern for the health system.The aim of this study was to evaluate the behavior of periodontal tissues and abdominal aorta artery in rats with hypothalamic obesity associated with experimental periodontitis. Material and Methods: Twenty-eight male Wistar rats were divided , initially, into 2 groups that were subjected to intradermal injections of 4G/kg of solution of Monosodium glutamate (MSG) and 1,25G/kg/day of saline solution (group CTL)in the cervical region, in the first 5 days of life. At 70 days, the groups were subdivided into 2 another groups, where was induced periodontitis with the ligation placing in 1s lower molars; creating in this way 4 groups: control group without ligation (CTL); control group with ligation (CTL Lig); group MSG without ligation (MSG); group MSG with ligation (MSG Lig). After 100 days the rats were weighed and the naso-anal lenght was measured, so the index of Lee was determined and, then, the animals were sacrificed. Gingival tissue and abdominal aorta samples, as well as the hemi-jaws were withdrawn for immunological, morphological and radiographic analysis. Results: The interleukin-6 concentration in gingival tissue was significant in CTL Lig group, being that the Tumor Necrosis Factor-alpha concentration in the abdominal aorta is higher in groups with experimental periodontitis (p< 0.05). Both the x-ray analysis as the histology showed a lower alveolar bone loss in the MSG Lig, group when compared to the CTL Lig group (p< 0.05). In the abdominal aorta morphometric analysis there was statistically significant 48 difference in the measurement of the artery wall diameter, being the largest diameter observed in the MSG Lig group (p< 0.05). Conclusion: Therefore, this study suggests that the periodontitis in association with the hypothalamic obesity may contribute to the increase of the width of the abdominal aorta walls, as well as the hypothalamic obesity may exert a protective effect on alveolar bone loss. / Objetivo: O objetivo desse trabalho foi avaliar o comportamento de tecidos periodontais e da artéria aorta abdominal em ratos com obesidade hipotalâmica associada a periodontite experimental. A doença periodontal é uma doença crônica que afeta grande parte da população e tem sido associada a alterações sistêmicas. Sendo assim, sua relação com a obesidade e a aterosclerose, é motivo de preocupação para o sistema de saúde. Metodologia: Vinte e oito ratos Wistar foram divididos, inicialmente, em 2 grupos que foram submetidos a injeções intradérmicas na região cervical de 4g/kg/dia de solução de Glutamato Monossódico (grupo MSG) e 1,25g/kg/dia de solução salina (grupo CTL), nos primeiros 5 dias de vida. Aos 70 dias, esse grupos foram subdivididos em outros 2 grupos, onde foi induzida a periodontite com a colocação de ligadura nos 1ºs molares inferiores; originando-se assim 4 grupos: grupo controle sem ligadura (CTL); grupo controle com ligadura (CTL Lig); grupo MSG sem ligadura (MSG); grupo MSG com ligadura (MSG Lig). Aos 100 dias os ratos foram pesados e mensurados o comprimento naso-anal, assim o índice de Lee foi determinado e, então, os animais foram sacrificados. Amostras de tecido gengival e da aorta abdominal, bem como as hemi-mandíbulas foram retiradas para análises imunológicas, morfológicas e radiográficas. Resultados: A concentração de interleucina-6 no tecido gengival foi significante no grupo CTL Lig, sendo a concentração do Fator de Necrose Tumoral alfa na aorta abdominal maior nos grupos com periodontite induzida (p<0.05). Tanto a análise radiográfica quanto a histológica demonstrou uma menor perda óssea alveolar no grupo MSG Lig, quando comparado ao grupo CTL Lig (p<0.05). Na análise morfométrica da aorta abdominal houve diferença estatisticamente significante na mensuração do diâmetro das paredes da artéria, sendo o maior diâmetro observado no grupo MSG Lig (p<0.05). Conclusion: Logo, este estudo sugere que a periodontite em associação com a obesidade hipotalâmica pode contribuir para o aumento da largura das paredes da aorta abdominal, bem como a obesidade hipotalâmica pode exercer um efeito protetor sobre a perda óssea alveolar.

A doença periodontal corresponde a um grupo de doenças inflamatórias que resultam na destruição das estruturas de suporte dental. São doenças infecciosas e possuem etiologia relacionada a microrganismos gram-negativos podendo manifestar-se de inúmeras maneiras. Estes possuem uma variedade de fatores que permitem o aumento de sua virulência e capacidade de se multiplicarem e persistirem no periodonto. Experimentos recentes de nosso laboratório mostraram que no tecido gengival de rato existe a expressão de RNAm para todos os componentes do Sistema Renina-Angiotensina (SRA), presença da renina e atividade da Enzima Conversora de Angiotensina I (ECA) em tecido gengival de ratos, sugerindo, assim, possível correlação entre o SRA e a doença periodontal (DP). Portanto, o objetivo do presente trabalho foi investigar se o captopril, um inibidor da ECA, altera a progressão da DP induzida experimentalmente em ratos. Para tanto, foi utilizado o modelo de indução da DP por colocação de ligadura ao redor do primeiro molar inferior de ratos divididos em grupos com 10 animais cada, que foram tratados com captopril (via gavagem, 30 mg/kg/dia) ou água (veículo). Foi realizado pré-tratamento com esta droga por 7 ou 14 dias previamente à indução da DP e após este período, o captopril foi administrado por 14 e 21 dias. Além disso, foi realizada cirurgia fictícia para indução da DP (grupo SHAM). As técnicas utilizadas neste trabalho foram: indução da DP em ratos, extração de RNA total, transcrição reversa seguida de reação em cadeia da polimerase quantitativa (RT-qPCR) e análise de perda óssea alveolar. Os dados foram analisados por meio de gráficos. Todos os resultados foram submetidos à análise unidirecional de variância (ANOVA) e representaram médias e respectivos desvios-padrão. Diferenças entre os grupos foram consideradas estatisticamente significativas quando p < 0,05. Com base nos resultados obtidos neste trabalho, foi possível concluir que o captopril não foi capaz de diminuir a perda óssea na doença periodontal induzida experimentalmente em ratos, apesar desta droga ter alterado a expressão de RNAm para um alvo do RAS (AT1a) e alguns mediadores do processo inflamatório no tecido periodontal, tais como COX-2, ECA-2, IL-6, RANKL, VEGF-R1 e VEGF-R2. / Periodontal disease (PD) consists of a group of inflammatory diseases which result in the destruction of tooth supporting structures. They are of infectious nature, with etiological factors related to gram-negative microorganisms, and may have manifestations in several ways. These comprise a variety of factors that allow the increase in its virulence and ability to multiply and persist in the periodontal tissue. Recent findings form our laboratory showed that mRNA expression exists in rat gingival tissue for all components of the Renin-Angiotensin System (RAS), the presence of renin as well as Angiotensin Converting Enzyme I (ACE) activity in rat gingival tissue, thus suggesting a possible correlation between the RAS and periodontal disease. Therefore, the aim of this study was to investigate whether captopril, an ACE inhibitor, alters the progression of experimentally-induced PD in rats. Thus, the model of PD induction by ligature placement around rat lower first molar was used. Animals were divided groups of 10 animals each, which were treated with captopril (via gavage, 30 mg/kg/day) or water (vehicle). Pre-treatment with this drug during 7 or 14 days was performed previously to PD induction, and after this period captopril was administered during 14 or 21 days. In addition, fictitious operation (SHAM group) was performed to induce PD. The techniques used in this study were: PD induction in rats, total RNA extraction, reverse transcriptionquantitative polymerase chain reaction (RT-qPCR) and alveolar bone loss. Data were analyzed by means of graphs. All the results were subjected to one-way analysis of variance (ANOVA) and represented means and respective standard errors. Differences between groups were considered statistically significant when p <0.05. Based on the results obtained in this study, it was concluded that captopril was not able to decrease bone loss in experimentally-induced PD in rats, although this drug altered the expression of mRNA for one RAS target (AT1a) and some mediators of inflammation in periodontal tissue such as, COX-2, ACE-2, IL-6, RANKL, VEGF-R1 and VEGF-R2.

A cárie e a doença periodontal são doenças crônicas da cavidade oral. A cárie dentária ainda continua sendo o principal problema de saúde bucal dos brasileiros. A maioria dos estudos de levantamento de cáries excluem os terceiros molares. A presença destes dentes pode levar à doença periodontal na região, e muitas vezes, pode levar à injúrias e prejuízo à saúde bucal do indivíduo, tendo um significativo impacto na qualidade de vida. A incidência de cárie e doença periodontal pode variar em função da posição do terceiro molar. Material e método: tratou-se de um estudo clinico, transversal, observacional, onde foram avaliados 116 pacientes que procuraram a triagem do curso de especialização de Cirurgia e Traumatologia Bucomaxilofacial da FUNDECTO-FFO-USP, para avaliação da necessidade de exodontia dos terceiros molares. As variáveis avaliadas foram: cárie, doença periodontal e qualidade de vida. A avaliação da cárie foi feita através de exame clínico com sonda exploradora e espelho clínico; a doença periodontal através de sondas milimetradas em dois pontos, considerando sua presença da doença quando bolsa maior que 4 mm, bem como, a presença radiográfica de ambos. A avaliação da qualidade de vida relacionada à saúde bucal, por meio do questionário Ohip-14, aplicado sobre forma de entrevista. A avaliação da posição dos terceiros molares realizou-se por meio da avaliação clínica e de radiografias panorâmicas, segundo a classificação de Pell e Gregory e Winter. O objetivo foi avaliar se a posição do terceiro molar interfere na incidência de cárie e doença periodontal, mensurar a qualidade de vida, e contribuir na tomada de decisão terapêutica de exodontia. Os dados foram analisados no pacote estatístico STATA 13.0, com estatística descritiva e inferencial. O nível de significância utilizada foi de 95%. Resultados: angulação e semierupção aumentam a incidencia de cárie e doença periodontal em terceiros molares. Sintomas e idade são fatores associados a cárie e Dp. Cáries nos superiores alteram domínios 3 e 6 e Dp nos inferiores alteram domínios 3 e 4. Alterações patológicas na região alteram o domínio 7. Conclusão: a posição dos dentes influenciam na incidência de cárie e doença periodontal em terceiros molares. Cárie e doença periodontal tem impacto na qualidade de vida. A Pesquisa teve aprovação do comitê de ética em pesquisa da FOUSP sob numero 280084. / Caries and periodontal disease are chronic diseases of the oral cavity. Dental caries still remains the main problem of oral health of Brazilians. Most clinical studies of caries do not consider third molar teeth. The presence of these teeth can lead to periodontal disease in the region, and often can lead to injuries and damage to the oral health, having a significant impact on the quality of life. The incidence of caries and periodontal disease can vary depending on the position of the third molar. Methods: We performed a clinical, observational cross-sectional study within 116 patients. That were screened attending to evaluate the need for extraction of third molars at the specialization course of Oral and Maxillofacial Surgery of FUNDECTO-FFO-USP. Caries, periodontal disease and quality of life are the outcomes that were evaluated by the main researcher. Caries lesions were assessed by visual tactile examination and periodontal disease through two probing sites around third molar, considering the presence of periodontal pathology when at least one periodontal probing depth was greater than 4 mm, and both were evaluated by radiograph diagnostic methods. The assessment of oral health related quality of life by Oral Health impact Profile questionary (OHIP-14), applied as an interview. The evaluation of the position of the third molars was made by clinical and panoramic radiographs according to the classification of Pell and Gregory and Winter. The aim of these study was to evaluate whether third molar position interferes with the incidence of caries and periodontal disease, in addition to measure the quality of life, and contribute in making treatment decisions for extraction. Data was treated and analyzed according to STATA 13.0, software with descriptive and inferential statistics. The level of significance used was 95%. Results: partially erupted and angulation of third molar increase the incidence of caries and periodontal disease in these teeth. Symptoms and age are factors associated with caries and periodontal disease. Patients with caries have higher scores in domains 3 and 6 and those with periodontal disease have higher scores in domains 3 and 4. Pathologies on third molar region had impact on domain 7. Conclusion: tooth position influence on the incidence of caries and periodontal disease in third molars. Caries and periodontal disease have impacts on the quality of life. The study had the approval of ethics committee from University of Sao Paulo Dental School (numero 280084).

This study was designed to compare the fatty acid and fruit and vegetable intake of people with and without periodontal disease. Periodontal disease affects approximately 15 percent of the developed world population. Participants filled out a food frequency questionnaire (FFQ) for both fruit and vegetable and fat intake. A sample of whole blood (EDTA) was collected to determine the fatty acid profile of participants’ red blood cell (RBC) membrane. This analytical procedure determines the average fatty acid intake of the participant over the previous 90 to 120 days. Participants were classified as case (n=10, patients diagnosed with periodontal disease) or control group (n=10, patients without periodontal disease). Our hypothesis was that the case group would have higher fat intake and lower fruit and vegetable intake, with lower levels of omega-3 fatty acids and higher levels of omega-6 fatty acids in the RBC membrane. FFQ results indicated that case participants consumed significantly higher amounts of total fat (109.02 vs. 94.46g/d; p= .05), saturated fat (35.102 vs. 28.242g/d; p= .033) and their diets had a higher percentage of total dietary fat (38.73% vs. 34.99%; p=.044). FFQ for fruit and vegetable intake showed no significance between the case and control groups (4.41 vs. 4.56 servings/d; p=.871). For the most part, there were no significant differences between the percent composition of the individual fatty acids isolated from the RBC membrane or in ratios of omega-3 to omega-6 fatty acid groups as determined by RBC fatty acid analysis. Results indicated a numerically lower intake of omega-3 fatty acids in the case than in the control group. Likewise, there was a numerically higher intake of omega-6 fatty acids in the case group. These numbers demonstrate a trend towards the hypothesis being correct and patients with periodontal disease consuming more omega-6 fatty acids and less omega-3 fatty acids.

Objective: To investigate and determine periodontal treatment needs by the use of the Community Periodontal Index of Treatment Needs (CPITN) of a Medicaid expansion population in the state of Iowa (DWP) in comparison with patients insured by the traditional Medicaid State Plan, patients with private dental insurance, and self-pay patients, while evaluating for systemic health conditions and socio-behavioral factors. Methods: A secondary data analysis of electronic health records (EHR) from the University of Iowa College of Dentistry was completed and analyzed. Univariate and bivariate analyses were conducted. Logistic regression models were used to analyze relationships between predictors and periodontal treatment need. Results: Out of the study population, 54% were indicated for scaling and root planing (SRP). Predictors of indicating the need for SRP treatment were found to be: Age (p< .0001), gender (p< .0001), medical diagnosis of diabetes (p=.031), smoking status (p< .0001), and not receiving regular dental check-ups (p< .0001). Discussion: Our findings are consistent with common periodontal disease predictors found in the literature. Interestingly, insurance status was not a significantly associated predictor of periodontal treatment needs. However, approximately 50% patients with all insurance types were indicated for SRP. Implications: DWP patients must earn benefits by maintaining dental appointments. This earned benefits approach delays periodontal treatment as patients must earn this procedure, potentially leading to deteriorating periodontal health. Further assessment of periodontal burden in the DWP population should be conducted and potential program structure evaluated.

acase@tulane.edu

"December, 2002" Includes bibliographical references (leaves 211-238)

Bibliography: leaves 235-253. / xx, 431 leaves ; 30 cm. / Title page, contents and abstract only. The complete thesis in print form is available from the University Library. / Examines the association between employment of dental hygienists and the patterns of delivery of diagnostic, preventive and treatment periodontal procedures and assesses the effectiveness of a continuing education intervention in altering the delivery of diagnostic, preventive and treatment periodontal services by practices employing and not employing dental hygienists in Adelaide, South Australia. / Thesis (Ph.D.)--University of Adelaide, Dept. of Dentistry, 1994?

In the past two decades studies have indicated that oral health might be associated with the prevalence for cardiovascular disease (CVD), although the biological link still remains unknown. Bacteria and inflammatory mediators causing periodontal disease have also been suggested to influence the progression of atherosclerosis. The aims of this thesis were to study oral inflammation and associations between different oral health parameters and CVD. Inflammatory mediators such as interleukin-1 (IL-1) as well as bone resorption activity (BRA) were significantly higher in gingival crevicular fluid (GCF) from sites with periodontal disease compared to healthy sites. Treatment resulted in a reduction of BRA as well as the levels of IL-1 for most of the diseased pockets. The levels of IL-1 were not correlated to the amount of BRA. Number of teeth (NT) was consistently associated to CVD and was the only oral health parameter that related to all-cause mortality and mortality in CVD in a dose-dependent manner. Subjects with &lt;10 teeth had a 7-fold increase risk for mortality in coronary heart disease compared to those with &gt;25 teeth. Furthermore, NT was also significantly associated to the levels of leukocytes and to the metabolic syndrome, which consists of a combination of cardiovascular risk factors. Other investigated oral health parameters, such as severity of periodontal disease, number of deepened pockets, and bleeding on probing, were not related to CVD in a consistent way. Oral health parameters as well as myocardial infarction (MI) were related to serum antibody levels against Porphyromonas gingivalis (Pg), indicating that Pg might be a link between oral health and MI. In conclusion, treatment reduced the increased levels of IL-1 and BRA in GCF from sites with periodontal disease. Oral health was associated to CVD with number of teeth being the only oral health parameter that consistently was associated to CVD. Serum antibody levels against P. gingivalis were related to myocardial infarction (MI) as well as to oral health parameters, suggesting that this bacteria could be a link between oral health and CVD.